Provider Demographics
NPI:1346530052
Name:NASTASIU, MEI (OMD)
Entity Type:Individual
Prefix:
First Name:MEI
Middle Name:
Last Name:NASTASIU
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9535 RESEDA BLVD
Mailing Address - Street 2:SUITE 3001
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91324-2310
Mailing Address - Country:US
Mailing Address - Phone:818-288-3708
Mailing Address - Fax:818-718-2259
Practice Address - Street 1:9535 RESEDA BLVD
Practice Address - Street 2:SUITE 3001
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-2310
Practice Address - Country:US
Practice Address - Phone:818-288-3708
Practice Address - Fax:818-718-2259
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 8943171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist